Children's Ambulatory Surgery Center of New Jersey, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CHILDREN'S AMBULATORY SURGERY CENTER OF NEW JERSEY, LLC

Practice address

14-01 Broadway
Fair Lawn, NJ 07410-2001

Phone

(291) 791-0100

Fax

(201) 791-8800

NPI assigned

Sep 28, 2011

Last updated

Oct 11, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John H Hajjar, MD

Title

President/Ceo

Phone

(201) 834-1100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639452444. Details of each certification follow.

• CCN 31C0001302 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 31C0001302

Legal name

CHILDREN'S AMBULATORY SURGERY CENTER OF NEW JERSEY

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Nov 12, 2013

Last certification

Nov 7, 2019

Ownership / control type

Proprietary

Facility address

14-01 Broadway
Fair Lawn, NJ 07410

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• St Josephs University Medical Center Inc.

  • General Acute Care Hospital
  • Paterson, NJ
  • NPI 1669462420

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476144000000",
    "number": "1639452444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 HARRISTOWN RD",
            "address_2": "SUITE 200",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074523307",
            "telephone_number": "201-834-1100",
            "fax_number": "201-599-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14-01 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102001",
            "telephone_number": "291-791-0100",
            "fax_number": "201-791-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S AMBULATORY SURGERY CENTER OF NEW JERSEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-28",
        "last_updated": "2016-10-11",
        "status": "A",
        "authorized_official_last_name": "HAJJAR",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "201-834-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Children's Aid and Family Services, Inc.
• Children's Aid and Family Services, Inc.
• Children's Aid and Family Services, Inc.
• Children's Aid and Family Services, Inc.
• Children's Aid and Family Services, Inc.
• Melissa A Chism, MD
• Hee Cho, DC
• Soung Ick Cho, M.D.
• Sun Cho
• Kayla Yoorim Choi, MA, LPC, LMHC

• Ambulatory Surgical Clinic/Center in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Ambulatory Surgical Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.